The Legacy of Lean

Recovery Unplugged Blog
Dominic Nicosia

Written By

Dominic Nicosia

Some know it as “lean,” some know it as codeine-promethazine and many don’t know it at all. Although blues musicians were mixing cough syrup and alcohol back in the 1960’s, that doesn’t mean they had a name for it. Nevertheless, the newest incarnation of this formula, also commonly known as “sizzurp” and “purple drank,” has continued through the decades and has left an indelible mark on the Houston hip-hop community, claiming many of its most celebrated figures along the way. Throughout its evolution, lean has undergone several ingredient changes and now consists primarily of alcohol, cough syrup, some type of soft drink and sometimes fruit-flavored hard candy.

Some of the more notable proponents of lean include Houston hip-hop innovator DJ Screw (who died of complications related to the drug and whose signature sound was often linked to it), Big Moe, Z-Ro. H.A.W.K, Three 6 Mafia and UGK. Big Moe died from a heart attack at 33 and, although his death was not directly attributed to codeine overdose, he was an avid consumer of lean. Another high-profile lean-related death occurred a short time after Big Moe’s when Houston hip-hop fixture Pimp-C passed away in his Los Angeles hotel room. Pimp-C’s death was the result of a combination of codeine-promethazine use and sleep apnea. Since then there have been a number of Houston rappers that have discussed their personal experiences with lean and the negative impact it’s had on hip-hop culture.

Some of the main effects of lean include lethargy, impairment of motor skills, decelerated heart rate, respiratory distress and more. Though its dangers have been well documented, lean is enjoying a younger and younger consumer base, particularly around the Houston area. A 2008 study found that 10 percent of American teenagers had abused cough syrup to get high. It is commonly used alongside simultaneously with other drugs. One of the more dangerous and immediate effects of lean is that its ability to depress the central nervous system, stopping the heart and lungs. This is an effect similar to the kind experienced when mixing alcohol and benzodiazepines.

There is increasing opinion that the dangers of lean should be thoroughly explained by the hip hop community and that a problem that started in Houston should be addressed there. Regardless of where one chooses place culpability in the proliferation of lean, the drug has proven to be one more in a series of deadly substance abuse threats facing the state of Texas.

Dominic Nicosia

Dominic Nicosia

Dominic Nicosia, a seasoned content writer, brings a wealth of knowledge and expertise to the realm of healthcare writing, particularly in the addiction care field. Holding a Bachelor's Degree in Communications and Professional Writing from the University of the Arts Philadelphia (2009), Dominic has carved a niche for himself with over seven years of specialized writing experience in addiction care.

As the Senior Content Writer at Recovery Unplugged, Dominic is entrusted with the pivotal role of curating and overseeing the online blog, ensuring its alignment with the highest standards of accuracy, relevance, and trustworthiness. His responsibilities extend beyond the blog, encompassing all written communications within the Marketing domain. From articles and thought leadership pieces to web content, Dominic's penmanship is evident in every written facet of Recovery Unplugged.

Dominic's credibility is further enhanced by his contributions to esteemed publications like Austin Fit Magazine, where he delves into critical topics such as drug use, addiction, recovery, and mental health. His writings not only reflect his profound understanding of the subject matter but also resonate with readers, offering insights and guidance. Outside the professional sphere, Dominic's passion for music is evident. He has been writing and playing music for years, showcasing his versatility and depth as a writer and artist.

Dominic Nicosia stands as a beacon of expertise and credibility in the healthcare writing community. With a deep understanding of his subject matter and a commitment to accuracy, he consistently delivers content that is both informative and reliable, meeting the highest standards of quality and trustworthiness in the industry.


  • Proven track record in managing and enhancing online blogs, articles, and thought leadership pieces.
  • Adept at blending his passion for music with his writing, offering a unique perspective on topics.


  • Bachelor's Degree in Communications and Professional Writing from the University of the Arts Philadelphia (2009).
    • Call Now: (855) 384-5794